The Performance Of Hemoglobin A1C Against Fasting Plasma Glucose And Oral Glucose Tolerance Test In Detecting Prediabetes And Diabetes

Background: In recent years, hemoglobin A1c (HbA1c) is accepted among the algorithms used for making diagnosis for diabetes and prediabetes since it does not require subjects to be prepared for giving a blood sample. The aim of this study is to assess the performance of HbA1c against fasting plasma glucose (FPG) and oral glucose tolerance test (OGTT) in detecting prediabetes and diabetes. Materials and Methods: A total of 315 subjects were included in this study. The success of HbA1c in distinguishing the three diagnostic classes was examined by three-way receiver operating characteristic (ROC) analysis. The best cut-off points for HbA1c were found for discriminating the three disease status. Results: The performance of HbA1c, measured by the volume under the ROC surface (VUS), is found to be statistically significant (VUS = 0.535, P < 0.001). The best cut-off points for discriminating between normal and prediabetes groups and between prediabetes and diabetes groups are c1 = 5.2% and c2 = 6.4% respectively. Conclusion: The performance of HbA1c in distinguishing between the prediabetes and diabetes groups was higher than its ability in distinguishing between healthy and prediabetes groups. This study provides enough information to understand what proportion of diabetes patients were skipped with the HbA1c especially when the test result is healthy or prediabetes. If a subject was diagnosed as healthy or prediabetes by HbA1c, it would be beneficial to verify the status of that subject by the gold standard test (OGTT and FPG).PubMe

Prediction of Central Lymph Node Metastasis in Patients with Thyroid Papillary Microcarcinoma

Background/aim: The purpose of this study was to analyze the clinicopathological characteristics of patients with papillary thyroid carcinoma (PTC) and papillary thyroid microcarcinoma (PTMC) and predictive factors for central lymph node metastasis (CLNM). Materials and methods: Patients diagnosed as having PTC and PTMC were evaluated. Clinical and laboratory parameters were recorded. Results: The mean age at diagnosis was 47.3 +/- 11.9 years. Of all 223 patients, 91 (40.8%) had lymph nodes removed, 29 of whom had lymph node metastasis and 24 of whom had only CLNM. Univariate analysis revealed that central lymph node metastasis was associated with male sex, presence of bilaterality, presence of extrathyroidal extension, and tumor size (P = 0.033, P = 0.027, P < 0.001, P < 0.001, respectively). However, multivariate logistic regression analysis showed that sex, age, tumor size, multifocality, bilaterality, extrathyroidal extension, clinical suspicion, and chronic lymphocytic thyroiditis were not significantly correlated with an increased risk for CLNM. Conclusion: Lymph node metastasis is known to be a significant predictor of locoregional recurrence in patients with PTC and PTMC. Further prospective studies are needed to identify the extent of surgery such as central lymph node dissection in patients with PTC or PTMC.WoSScopu

Tumor budding and E-Cadherin expression in endometrial carcinoma: Are they prognostic factors in endometrial cancer?

Objective. To evaluate the prognostic value of tumor budding (TB) in endometrioid (EEC) and non-endometrioid endometrial cancers (NEEC) and to determine its correlation with expression of E-cadherin

Muscle function-dependent sarcopenia and cut-off values of possible predictors in community-dwelling Turkish elderly: Calf circumference, midarm muscle circumference and walking speed

© 2015 Macmillan Publishers Limited. All rights reserved.Background/Objectives:The aim of this study was to determine the prevalence of muscle strength-based sarcopenia and to determine possible predictors.Subjects/Methods:This is a cross-sectional population-based study in the community-dwelling Turkish elderly. Anthropometric measurements, namely body height, weight, triceps skin fold (TSF), mid upper arm circumference (MUAC), waist circumference (WC) and calf circumference (CC), were noted. The midarm muscle circumference (MAMC) was calculated by using MUAC and TSF measurement. Sarcopenia was assessed, adjusted for body mass index (BMI) and gender, according to muscle strength. Physical performance was determined by 4 m walking speed (WS; m/s). The receiver operating curve analysis was performed to determine cut-offs of CC, MAMC and 4 m WS.Results:A total of 879 elderly subjects, 50.1% of whom were female, were recruited. The mean handgrip strength (HGS) and s.d. was 24.2 (8.8) kg [17.9 (4.8) female, 30.6 (7.1) male]. The muscle function-dependent sarcopenia was 63.4% (female 73.5%, male 53.2%). The muscle mass-dependent sarcopenia for CC (<31 cm) and MAMC(<21.1 cm in males, <19.9 cm in females) was 6.7% and 7.3%, respectively. The prevalence of low 4 m WS (≤0.8 m/s) was 81.8% (91.3% in females and 72.3% in males, respectively). We compared MAMC, CC and 4 m WS and found that AUC for 4 m WS was the best predictor of sarcopenia.Conclusions:An adequate muscle mass may not mean a reliable muscle function. Muscle function may describe sarcopenia better compared with muscle mass. The CC, MAMC and 4 m WS cut-offs may be used to assess sarcopenia in certain age groups

The prevalence and related factors of restless leg syndrome in the community dwelling elderly; in Kayseri, Turkey: A cross-sectional study

Aim: The aim of this study is to determine the prevalence and related factors of restless leg syndrome (RLS) in the community-dwelling elderly living in Kayseri

The impact of sleep duration on frailty in community-dwelling Turkish older adults

© 2020, Japanese Society of Sleep Research.The aim of this study was to examine the association between sleep duration and frailty in community-dwelling Turkish older adults and to determine whether this association varies depending on gender. A cross-sectional study was conducted from August 2013 to December 2013 with 905 individuals, representative of the aged population ≥ 60 years in community-dwelling elderly. Self-reported sleep duration was classified as short sleep duration (≤ 6 h), middle sleep duration (6.1–8.9 h), and long sleep duration (≥ 9 h). Frailty was assessed according to the FRAIL scale (FRAIL: Fatigue, Resistance, Ambulation, Illness, Low weight).The study included 905 community-dwelling older adults (447 male and 458 female). The median (25p–75p) age of the study population was 71.0 years (67.0–75.0) (range 60–92 years). The number of patients according to the short, middle, and long sleep durations were 120 (13.3%), 341 (37.7%), and 433 (47.8%), respectively. The median duration of sleep time in the total study population was 8.5 (7.0–10.0) h. According to frailty status, the percent of robust subjects was higher in the group with mid sleep duration than the other two groups (p = 0.020). Short sleep duration was associated with frailty in the female gender in both the unadjusted model (OR 2.80, 95% CI 1.42–5.52) and the fully adjusted model (OR 3.42, 95% CI 1.50–7.77). Short sleep duration is independently associated with frailty in community-dwelling Turkish female older adults, thus frailty prevention interventions should consider sleep duration in females

Validity of simplified nutritional appetite questionnaire for Turkish community-dwelling elderly and determining cut-off according to mini nutritional assessment

© 2019Background/Objectives: The aim of this study was to determine a cut-off value for the SNAQ according to both the MNA long and MNA short forms and to assess whether the SNAQ can predict malnutrition or risk of malnutrition in the elderly. Subjects/Methods: Nutritional status was assessed both by the Mini Nutritional Assessment (MNA) long and short forms. All demographic characteristics, mental status, depressive mood, functional status, and frailty were determined. Receiver operating characteristic (ROC) curves were used to calculate the cut-off of the SNAQ according to both the MNA long and short forms for malnutrition or risk of malnutrition. Reliability and validation of the SNAQ was analysed. Results: We included 905 community-dwelling elderly, but those with middle-stage dementia (MMSE score <18, n = 30) were excluded. The mean age ± standard deviation (SD) was 71.4 ± 5.5 years (49.3% female and 50.7% male). The prevalence of well-nourished, risk of malnutrition or malnutrition were 55.2%, 44.8%, respectively according to the MNA-long form. The prevalence of elderly at risk of future weight loss (SNAQ score of ≤14) was 31.0% (n = 268; 66.0% female, 34.0% male). The area under the curve (AUC) for SNAQ was 0.725 (95% CI 0.690–0.760). The cut-off value of the SNAQ, according to both the MNA long and short forms, was 14 (sensitivity; 50%, 50% and specificity; 84%, 82%, respectively). The Cronbach's alpha reliability coefficient of SNAQ for internal consistency was 0.639. Conclusion: The SNAQ was reliable and valid as an appetite screening tool in community-dwelling Turkish elderly

The prevalence of frailty and related factors in community-dwelling Turkish elderly according to modified Fried Frailty Index and FRAIL scales

The purpose of this study is to determine the prevalence of frailty with the Fried Frailty Index (FFI) and FRAIL scales (Fatigue, Resistance, Ambulation, Illness, Low weight) and also its associated factors in the community-dwelling Turkish elderly

Nutritional status and related risk factors which may lead to functional decline in community-dwelling Turkish elderly

Results: A total of 845 elderly were included. Their mean age and standard deviation (SD) of age were 71.6 (5.6) (52% were male). The mean and SD of MNA score was 23 (3.0), of these 42.2% were at risk of malnutrition (MNR) and 3.3% were malnutrition (MN). In logistic regression analysis, odds of low income (OR: 0.5, 95% CI: 0.321-0.849), decreased mid-upper arm circumference (MUAC) (OR: 0.9, 95% CI: 0.873- 0.973), decreased waist circumference (WC) (OR: 0.9, 95% CI: 0.970-0.999), increased depressive mood (OR: 0.26, 95% CI0.176: 0.389), diabetes mellitus (OR: 1.7, 95% CI: 1.178-2.601), living alone (OR: 1.9, 95% CI: 1.189-3.150) and increased 4-m walking speed (m/s) (OR: 1.1, 95% CI: 1.05-1.248) were independently associated with possible poor nutrition. Conclusions: Significant risk factors for poor nutrition can be grouped as clinical conditions; depressive mood and diabetes mellitus, anthropometric measurements; WC and MUAC, social factors; low income and living alone, functionality; increased 4-m walking speed (m/s). © 2014 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.Purpose: The objective of this study is to assess the nutritional status in community-dwelling elderly and to describe risk factors which may cause poor nutrition related functional decline.Methods: This is a cross-sectional population-based study in urban area where more than one million population lives. Community-dwelling elderly were sampled as 1/100 from this population. Nutritional status was assessed by the Mini Nutritional Assessment (MNA). All demographic characteristics and risk factors which may contribute to functional decline were reviewed. Logistic regression analyses were performed to identify independent risk factors over nutritional status